Zhang Fengjian, Huang Lei, Fei Yang, Peng Xiao, Liu Yilan, Zhang Ning, Chen Cheng, Chen Jie
Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
School of Nursing, Xinxiang Medical University, Xinxiang, 453003, China.
BMC Nurs. 2024 Oct 6;23(1):716. doi: 10.1186/s12912-024-02388-9.
Previous studies have established a positive link between nurse managers' caring leadership and nurses' work engagement, but the processes and conditions through which this leadership style influences positive work behaviors remain largely unexplored. To address this gap and contribute to the existing body of knowledge, we developed a chain-mediated effects model to elucidate the impact of caring leadership on nurses' work engagement and the underlying mechanisms. In this model, we identified professional mission and affective organizational commitment as the mediating variables, offering a novel perspective on the relationship between caring leadership and work engagement.
A robust multi-center and large-sample cross-sectional survey was conducted, involving 2502 first-line nurses from six general tertiary hospitals across the eastern, central, and western regions of China. The data collection instruments included a comprehensive questionnaire covering demographic information, the caring leadership scale, the Chinese calling scale, the affective organizational commitment scale, and the Utrecht work engagement scale. Data were meticulously screened and analyzed, employing descriptive analysis to summarize the demographic information, correlation analysis to test the relationship among the variables, stepwise regression analysis to explore the mediating role of calling and affective organization commitment, and the bootstrap method to test the chain mediating effect. This rigorous methodology not only ensures the reliability and validity of research findings but also instills confidence in the robustness of this research.
The results indicated a positive relationship among caring leadership, calling, affective organizational commitment, and nurses' work engagement (p < 0.001). Specifically, caring leadership was significantly associated with nurses' calling (β = 0.55, p < 0.001), affective organizational commitment (β = 0.21, p < 0.001), and work engagement (β = 0.05, p < 0.001). And the analysis further revealed that calling and affective organizational commitment mediate the process between caring leadership and work engagement(Effect: 0.17, 0.03, 0.05), with a relative effect size of 89.3% for the total indirect effect. These findings highlight the crucial role of these factors in enhancing nurses' work engagement, providing valuable insights for healthcare leaders and policymakers.
Caring leadership positively predicts nurses' work engagement and indirectly mediates calling and affective organizational commitment. The results of this study revealed that the mechanisms of caring leadership influence nurses' work engagement, which provides a new approach to strengthening nurses' work engagement and improving patient healthcare outcomes and organizational performance. Healthcare organizations face continuous challenges; this study embodies the significance of caring leadership in improving nurses' work experience and increasing their work engagement. Nursing managers should enhance their knowledge of caring leadership and receive caring leadership training, thus actively improving their leadership behaviors in nurse management, enhancing leadership effectiveness, and creating more possibilities for developing healthcare organizations.
以往研究已证实护理管理者的关怀型领导与护士的工作投入之间存在正向关联，但这种领导风格影响积极工作行为的过程和条件在很大程度上仍未得到探索。为填补这一空白并丰富现有知识体系，我们构建了一个链式中介效应模型，以阐明关怀型领导对护士工作投入的影响及其潜在机制。在该模型中，我们将职业使命感和情感组织承诺确定为中介变量，为关怀型领导与工作投入之间的关系提供了新视角。
开展了一项强大的多中心大样本横断面调查，涉及来自中国东部、中部和西部六个大型三级综合医院的2502名一线护士。数据收集工具包括一份综合问卷，涵盖人口统计学信息、关怀型领导量表、中国职业使命感量表、情感组织承诺量表和乌得勒支工作投入量表。对数据进行了精心筛选和分析，采用描述性分析总结人口统计学信息，采用相关性分析检验变量间的关系，采用逐步回归分析探索职业使命感和情感组织承诺的中介作用，采用 Bootstrap 方法检验链式中介效应。这种严谨的方法不仅确保了研究结果的可靠性和有效性，也增强了对本研究稳健性的信心。
结果表明，关怀型领导、职业使命感、情感组织承诺与护士的工作投入之间存在正相关关系（p < 0.001）。具体而言，关怀型领导与护士的职业使命感（β = 0.55，p < 0.001）、情感组织承诺（β = 0.21，p < 0.001）和工作投入（β = 0.05，p < 0.001）显著相关。进一步分析表明，职业使命感和情感组织承诺在关怀型领导与工作投入之间起中介作用（效应值分别为0.17、0.03、0.05），总间接效应的相对效应量为89.3%。这些发现凸显了这些因素在提高护士工作投入方面的关键作用，为医疗保健领导者和政策制定者提供了有价值的见解。
关怀型领导能正向预测护士的工作投入，并间接中介职业使命感和情感组织承诺。本研究结果揭示了关怀型领导影响护士工作投入的机制，为增强护士工作投入、改善患者医疗结局和组织绩效提供了新途径。医疗保健组织面临持续挑战；本研究体现了关怀型领导在改善护士工作体验和提高其工作投入方面的重要性。护理管理者应增强对关怀型领导的认识并接受关怀型领导培训，从而积极改善其在护士管理中的领导行为，提高领导效能，为医疗保健组织的发展创造更多可能性。
